The Pentagon's personnel and readiness chief lauded the 1,400 military health care professionals for their efforts to successfully implement TRICARE, DoD's managed health care plan. "If you want to know why the system works, you only need to look at the people in the [Military Health System]," de Leon said. "Your work does not go unnoticed. While there are challenges and issues before us, I have great confidence in your skills."

de Leon then urged the medics to adopt "seven priorities that are critical to the military health system:"

Protecting deployed forces from health hazards. de Leon said the medics should focus on sickness prevention, hazard protection and keeping troops healthy for deployment. He listed immunizations and training service members how to protect themselves in a nuclear, biological and chemical environment.

Improving access to health care. de Leon noted that while there has been a concerted effort to improve appointment systems at military hospitals and clinics, "the critics have the high ground. It's tough to get in," he said. "We have to work better."

Taking care of older patients. de Leon said DoD has to find a way to take care of patients 65 and older, who fall under Medicare rules. Although he expressed optimism the Medicare subvention package now at the Department of Health and Human Services will soon open military facilities to the elderly, he said DoD also is studying other options for the future. "In the short term, however, TRICARE Senior [enrollment of the over-65 population in TRICARE] will be one of our highest priorities," he said.

Promoting health and wellness. He cited statistics showing smoking, taking drugs and heavy drinking are all down within DoD, and that improves military readiness. "The armed forces is a model for American society," he said, but told the medics the battle against substance abuse must be ongoing.

Sharing more resources and information with the Department of Veterans Affairs. de Leon said DoD and VA continue discussing ways to better interact, and a congressional commission is studying the relationship between DoD and VA medical facilities.

Leveraging information technology. de Leon said he strongly backs two major medical initiatives: computerized health records and the new Personal Identification Carrier. The latter program would digitally stamp medical information onto "dog tags" soldiers would carry with them into battle. The Army is currently field-testing the devices, and early reports of their effectiveness have been positive.

Communicating. "People in the field are not always well-versed in what the health care community is doing for them," de Leon said. He said a lack of information about health programs prompts lower usage of military medical facilities, something he's personally seen during field trips. "Think about how you can let them know how your [medical treatment facility] measures up," he said. He also encouraged them to meet with periodically with their customers, including line commanders, troops, retirees and other beneficiaries.

de Leon voiced strong concern about the health care needs of military retirees. "How we treat retirees is an important display of how we will treat the current active duty force when they are retired," he said.

"While we have a system in transition, it is a system dedicated to excellence," de Leon concluded. He thanked Dr. Ed Martin, acting assistant secretary of defense for health affairs, for guiding implementation of TRICARE since 1992. "I am going to miss you and would like to thank you for everything you have done for military medicine," he said. Martin, a rear admiral in the Public Health Service, retires next month after nearly 23 years' public service.